Conservatives back revised health bill, GOP moderates balk

Posted April 28, 2017

The Freedom Caucus includes 30 conservative Republican members who successfully blocked a GOP plan to hold a vote last month to repeal and replace the ACA.

House Republicans are closer to passing a health bill than theyve ever been, but its still not certain they can rack up enough votes for a win.

The proposed changes would let states get federal waivers to some coverage requirements President Barack Obama's law imposed on insurers.

Conservatives embraced the revisions as a way to lower people's health care expenses, but moderates saw them as diminishing coverage because insurers could make policies for their most ill - and expensive - customers too costly for them to afford. But those moderates in swing districts, unlike the members of the Freedom Caucus, could end up losing their seats if the repeal bill continues to remain unpopular.

White House officials and party leaders were eager for a vote this week if possible, before the 100th day of Donald Trump's presidency, which falls this Saturday.

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"If Republicans pursue this partisan path of forcing Americans to pay more for less and destabilizing our county's health care system - without even knowing how much their bill will cost - Republicans should be prepared to pass a one-week Continuing Resolution on their own", Hoyer said.

According to Vox, the statement says: "Congressman MacArthur does not believe Members of Congress or their staff should receive special treatment and is working with House Leadership to make absolutely clear that Members of Congress and staff are subject to the same rules, provisions, and protections as all other Americans".

Reps. Frank LoBiondo (R-2nd Dist.) and Leonard Lance (R-7th Dist.) also indicated that the changes negotiated by MacArthur (R-3rd Dist.) were not sufficient to get their votes.

The new amendment that won over the Freedom Caucus, written with Rep. Tom MacArthur (R., N.J.), a leader of the more centrist Tuesday Group, would allow states to apply for federal waivers to requirements in the Affordable Care Act, including that insurance plans cover a set list of essential health benefits, that prices have to be the same for people with pre-existing conditions, and caps on annual out-of-pocket costs.

Pressure from the White House and support from conservatives could put intense pressure on moderates to vote for the bill. Rand Paul (R-Ky.), one of the lead Senate agitators against the House health care push, said Wednesday. Enten calculates that 29 Republican senators, more than half the caucus, are more moderate on balance than the average House Republican, and yet those senators are now on the verge of being handed a bill that's more conservative than the first unpopular iteration was. Ted Cruz, R-Texas, a vocal foe of the House measure, calling the changes "a significant improvement". John McCain, R-Ariz., said that failing to do so is the GOP's fault.

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"It's pretty much everything I was looking for in terms of concessions", said Representative Scott DesJarlais of Tennessee, a member of the Freedom Caucus who had opposed an earlier version.

"They certainly haven't been particularly helpful in the process and a number of them have been busy rolling hand grenades across the Rotunda for about three months", said Rep. Tom Cole, R-Okla.

Most Americans want this approach, they said. Several conservative groups that had been opposed to previous proposals endorsed the Meadows-MacArthur plan Wednesday, including Heritage Action and Club for Growth.

Opponents included AARP representing older people, the Catholic Health Association of the United States and the American Academy of Family Physicians.

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